Many areas lack an appropriate place for homeless patients to recuperate after a hospital stay, which contributes to frequent readmissions and poor health outcomes. To address ths gap in transitional care, community stakeholders across the country have developed posthospital medical respite programs that promote recovery and offer a pathway to housing.
This case study describes how National Health Foundation, which operates home-like recuperative care facilities in Los Angeles, developed a sustainable business model by contracting with hospitals and Medicaid health plans. Contracts are structured around the provision of intensive care management, which promotes accountability for program outcomes. Almost three of five guests transition to stable housing or are reunited with family following their stay. READ MORE
In 2012, Massachusetts established a Health Policy Commission to lead collective efforts to make health care more affordable for its residents. The commission sets a statewide spending growth target and monitors payer and provider performance against it; investigates and reports on what’s driving the total cost of care; and issues data-driven policy reform recommendations.
This case study examines the origins, functions, and influence of Massachusetts’ experiment, providing lessons and insights for other states seeking new ways of controlling health costs. By engaging stakeholders in a shared cost-containment agenda, the Health Policy Commission has played a central role in coordinating a cross-sectoral effort to build a more efficient health care system in the state. READ MORE
Health Share is a nonprofit founded in 2012 to coordinate the provision of medical, dental, and behavioral health care for Medicaid beneficiaries in a tricounty region encompassing Portland, Oregon. It is one of 16 coordinated care organizations designated by the state to oversee and improve the delivery of services for a geographically defined population.
Health Share distributes per-capita payments to health plans and county-run mental health agencies that have agreed to accept risk for providing or ensuring access to defined services. These risk-bearing entities collaborate with community-based organizations to improve care for high-need, high-cost patients; achieve efficiencies by centralizing certain administrative and enrollment functions; and create accountability for performance. READ MORE
NOTE: These case studies were conducted under a contract with the Commonwealth Fund. The views expressed are the authors and do not necessarily reflect the views of the Commonwealth Fund or its officers, directors, or staff.